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813-780-0020 City ot �epnyrnnis rerr�u� hNN���a����� <br /> : Building Department <br /> Date Received �j " _1 � Phone Contact for Permitting ��� �d � �v / <br /> Owner's Name � U'"��r� Owner Phone Number �`�� 3 y3 `� Q� <br /> Owner's Address 3�''l �J Owner Phone Number � y! �`r — 9 <br /> Fee Simple Titleholder Nam • � Owner Phone Nurriber <br /> Fee Simple Titleholder dress . <br /> JOB ADDRESS ��� � d � J �� � � � � � LOT # �� <br /> , ,, /�` . � ��' <br /> SUBDIVISION �-i� PARCEL ID# � -" • <br /> (OBTAINED FROM P ERTYTA CE) 2� • !� (70� L" <br /> WORK PROPOSED NEW CONSTR ADD/ALT 0 SIGN 0 MOVE Q DEMOLISH vt?�' � <br /> � INSTALL B REPAIR <br /> PROPOSED USE � SFR �- COMM 0 OTHER <br /> TYPE OF CONSTRUCTION 0 BLOCK 0 FRAME 0 STEEL Q OTHER <br /> DESCRIPTION OF WORK SC'� n r� � <br /> BUILDING SIZE �� Xc7 7 5Q FOOTAGE CL��� HEIGHT <br /> [�] BUILDING $ ��O VALUATION OF TOTAL CONSTRUCTION <br /> ' AMP SERVICE PROGRESS ENERGY [� W.R.E.C. <br /> � ELECTRICAL $ L� <br /> �' PASCO PERMIT SERVICE <br /> PLUMBING $ <br /> (813) 788-5314 <br /> � MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION F� 1 '� - 824-7894 <br /> � GAS Q ROOFING � SPECIALTY � OTHER 'C' � w ��� <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA DYES QNO <br /> BUILDER � I �/� ��� i� � v COMPANY � � K /T • ���- <br /> SIGNATURE / `"r'� ' {�EGISTERED Y/ N FEE CURRENT Y/ N <br /> Address � '� License # <br /> ELECTRICIAN • COMAANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRENT Y/ N <br /> Address License # <br /> PLUMBER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRENT Y/ N <br /> Address License # � � <br /> MECHANICAL COMPANY . <br /> SIGNATURE REGISTERED Y/ N FEE CURRENT Y/ N <br /> Address License # <br /> OTHER � COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRENT Y/ N <br /> Address License # � <br /> RESID�NTIAL Attach (2) Plot Plans; (2) sets of Building Plans; (1) set of Energy Forms; R-O-W Permit for new construction, <br /> Minimum ten (10) worl<ing days after submittal date. Required onsite, Construction Plans, Stormwater Plans w/ Silt Fence installed, <br /> Sanitary Facilities & 1 dumps�er, Site Work Permit for subdivisions/large projecEs <br /> COMMERCIAL Attach (3) complete sets of Building Plans pl4s a Life Safety Page; (1) set of Energy Forms. R-O-W Permit for new construcfion. <br /> Minimum ten (10) worl<ing days after submittal dafe. Required onsite, Construction Plans, Stormwater Plans w/ Silt Fence installed, <br /> Sanitary Facilittes & 1 dumpster. Site 1Nor1< Permit for all new projects. All commercial requirements must meet compliance <br /> SIGN PERMIT Attaeh (2) sets of Engineered Plans. <br /> '*""PROPERTY SURVEY required for all NEW construction. <br /> Directions: <br /> Fili out application completely. <br /> Owner & Contractor sign back of application, notarized • <br /> If over $2500, a Notice of Commencement is required. (A!C upgrades over $5000) <br /> ** Agent (for the contractor) or Power of P;ttorney (for fhe owner) would be someone with notarized letter from owner authorizing same <br /> OVER THE COUNTER PERMITf'ING (Front of Application Only) � <br /> Reroofs Sewers Service.Upgrades A/C Fences (PIot/Survey/Footage) <br /> Driveways-Not over Counter if on public roadways.:needs ROW <br />